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Online ISSN 1827-1707
SHOLDER AND ELBOW SURGERY
Wiater B. P. 1, Wiater J. M. 1, 2
1 Department of Orthopaedic Surgery Beaumont Health System, Royal Oak, MI, USA;
2 Department of Surgery, Oakland University-William Beaumont School of Medicine Rochester Hills, MI, USA
Massive rotator cuff tears in young individuals are among the most challenging problems faced by the orthopaedic shoulder surgeon. These patients may present with complaints of pain, disability, or both. Tears can be acute, chronic, or acute-on-chronic. Several classification schemes of rotator cuff tears exist with massive tears making up one end of the spectrum in each. A thorough history and physical exam is necessary in the work-up of these patients. Diagnostic studies include plain films, magnetic resonance imaging, and/or ultrasound. Factors prognostic of an irreparable tear include tear size, a narrowed acromiohumeral interval, and fatty atrophy of the muscle bellies. Options of management include conservative or surgical treatments. Surgical options vary widely and should be individualized based on the needs and expectations of the patient. Potential surgical treatments include debridement, complete repair, partial repair, autograft, allograft, or xenograft augmentation, tendon transfer, arthroplasty, and arthrodesis.